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Schilstra CE, Sansom-Daly UM, Ellis SJ, Trahair TN, Anazodo AC, Amiruddin A, Lindsay T, Maguire F, Wakefield CE, Lah S, Bland E, Lenthen K, Rifkin A, Awan A, Kittos T, Hanbury N, Tsalidis S, Patterson P, McDonald F, Fardell JE. Guidelines for Caring for the Social Well-Being of Adolescents and Young Adults with Cancer in Australia. J Adolesc Young Adult Oncol 2024; 13:8-29. [PMID: 37367208 DOI: 10.1089/jayao.2023.0027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2023] Open
Abstract
More than 1000 Australian adolescents and young adults (AYAs) are diagnosed with cancer annually. Many report unmet social well-being needs, which impact their mental health. Australian AYA cancer care providers lack guidance to address these needs well. We aimed to develop guidelines for caring for the social well-being of AYAs with cancer in Australia. Following the Australian National Health and Medical Research Council guidance, we formed a multidisciplinary working group (n = 4 psychosocial researchers, n = 4 psychologists, n = 4 AYA cancer survivors, n = 2 oncologists, n = 2 nurses, and n = 2 social workers), defined the scope of the guidelines, gathered evidence via a systematic review, graded the evidence, and surveyed AYA cancer care providers about the feasibility and acceptability of the guidelines. The guidelines recommend which AYAs should have their social well-being assessed, who should lead that assessment, when assessment should occur with which tools/measures, and how clinicians can address AYAs' social well-being concerns. A key clinician, who is knowledgeable about AYAs' developmental needs, should lead the assessment of social well-being during and after cancer treatment. The AYA Psycho-Oncology Screening Tool is recommended to screen for social well-being needs. The HEADSSS Assessment (Home, Education/Employment, Eating/Exercise, Activities/Peer Relationships, Drug use, Sexuality, Suicidality/Depression, Safety/Spirituality Assessment) can be used for in-depth assessment of social well-being, while the Social Phobia Inventory can be used to assess social anxiety. AYA cancer care providers rated the guidelines as highly acceptable, but discussed many feasibility barriers. These guidelines provide an optimal care pathway for the social well-being of AYAs with cancer. Future research addressing implementation is critical to meet AYAs' social well-being needs.
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Affiliation(s)
- Clarissa E Schilstra
- School of Clinical Medicine, Faculty of Medicine and Health, UNSW Sydney, Kensington, Australia
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia
| | - Ursula M Sansom-Daly
- School of Clinical Medicine, Faculty of Medicine and Health, UNSW Sydney, Kensington, Australia
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia
- Sydney Youth Cancer Service, Prince of Wales Hospital, Sydney, Australia
| | - Sarah J Ellis
- School of Clinical Medicine, Faculty of Medicine and Health, UNSW Sydney, Kensington, Australia
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia
| | - Toby N Trahair
- School of Clinical Medicine, Faculty of Medicine and Health, UNSW Sydney, Kensington, Australia
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia
| | - Antoinette C Anazodo
- School of Clinical Medicine, Faculty of Medicine and Health, UNSW Sydney, Kensington, Australia
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia
| | - Azhani Amiruddin
- Western Sydney Youth Cancer Service, Westmead Hospital, Wentworthville, Australia
| | | | - Fiona Maguire
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia
- Sydney Youth Cancer Service, Prince of Wales Hospital, Sydney, Australia
| | - Claire E Wakefield
- School of Clinical Medicine, Faculty of Medicine and Health, UNSW Sydney, Kensington, Australia
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia
| | - Suncica Lah
- School of Psychology, Faculty of Science, University of Sydney, Sydney, Australia
| | - Elizabeth Bland
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia
| | | | - Allison Rifkin
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia
| | - Adry Awan
- Cancer Survivor and Advisor, Sydney, Australia
| | | | | | | | - Pandora Patterson
- Canteen, Sydney, Australia
- Faculty of Medicine, University of Sydney, Sydney, Australia
| | - Fiona McDonald
- Canteen, Sydney, Australia
- Faculty of Medicine, University of Sydney, Sydney, Australia
| | - Joanna E Fardell
- School of Clinical Medicine, Faculty of Medicine and Health, UNSW Sydney, Kensington, Australia
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia
- Western Sydney Youth Cancer Service, Westmead Hospital, Wentworthville, Australia
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Bradford N, Pitt E, Rumble S, Cashion C, Lockwood L, Alexander K. Persistent Symptoms, Quality of Life, and Correlates with Health Self-Efficacy in Adolescent and Young Adult Survivors of Childhood Cancer. J Adolesc Young Adult Oncol 2021; 11:410-418. [PMID: 34582267 DOI: 10.1089/jayao.2021.0104] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Purpose: The numbers of adolescent and young adult (AYA) survivors of childhood cancer are exponentially growing. To ensure suitable services are available to meet the needs of this growing population, understanding the experience of late effects, quality of life, and potentially modifiable factors, such as self-efficacy, is required. Methods: AYA survivors of childhood cancer recruited through an After Cancer Therapy Service at a Children's Hospital rated their symptoms experience, quality of life, and self-efficacy using the Patient Reported Outcome Common Terminology Criteria for Adverse Events, Functional Assessment of Cancer Therapy-General (FACT-G), and Patient-Reported Outcomes Measurement Information System (PROMIS®), respectively. Descriptive statistics were used to characterize the sample. Quality-of-life scores were compared with population norms. Regression analyses were used to explore the relationships between symptom experience, quality of life, and self-efficacy. Results: Thirty participants (mean age 22 ± 4.4 years) reported an average of nine symptoms as persistently experienced at moderate or higher rated intensity among participants (standard deviation ±8.7; range: 0-32; interquartile range: 2-16); over half (n = 17, 56.7%) had finished treatment 10 or more years ago. Participants scored lower on the FACT-G Physical Well-being and Emotional Well-being, and higher on Social Well-being subscales than the general population. Around two-thirds of participants were confident in their ability to self-manage their health based on their health self-efficacy score. Bivariate linear regression identified a statistically significant increase in the overall quality of life with increased self-efficacy, adjusted for age and sex (0.60, 95% confidence interval [CI] 0.30-0.90, p < 0.01). Higher symptom burden was associated with a lower overall quality of life after adjusting for age and sex (-0.95, 95% CI: -1.35 to -0.54, p < 0.001). Conclusion: Young cancer survivors experience a substantial number of persistent symptoms related to their cancer treatment that may negatively impact aspects of their quality of life. Health self-efficacy is a potential target for future interventions.
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Affiliation(s)
- Natalie Bradford
- School of Nursing, Faculty of Health, Queensland University of Technology, Brisbane, Australia.,Cancer and Palliative Care Outcomes Centre at Centre for Children's Health Research, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Erin Pitt
- School of Nursing, Faculty of Health, Queensland University of Technology, Brisbane, Australia.,Cancer and Palliative Care Outcomes Centre at Centre for Children's Health Research, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Shelley Rumble
- Oncology Services Group, Queensland Children's Hospital, Children's Health Queensland Hospital and Health Service, South Brisbane, Australia
| | - Christine Cashion
- Oncology Services Group, Queensland Children's Hospital, Children's Health Queensland Hospital and Health Service, South Brisbane, Australia
| | - Liane Lockwood
- Oncology Services Group, Queensland Children's Hospital, Children's Health Queensland Hospital and Health Service, South Brisbane, Australia
| | - Kimberly Alexander
- School of Nursing, Faculty of Health, Queensland University of Technology, Brisbane, Australia.,Cancer and Palliative Care Outcomes Centre at Centre for Children's Health Research, Faculty of Health, Queensland University of Technology, Brisbane, Australia
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Walsh CA, Yi JC, Rosenberg AR, Crouch MLV, Leisenring WM, Syrjala KL. Factors associated with social functioning among long-term cancer survivors treated with hematopoietic stem cell transplantation as adolescents or young adults. Psychooncology 2020; 29:1579-1586. [PMID: 32628342 DOI: 10.1002/pon.5460] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 06/19/2020] [Accepted: 06/28/2020] [Indexed: 01/06/2023]
Abstract
OBJECTIVE Hematopoietic stem cell transplantation (HSCT) can compromise long-term health and social functioning. We examined the impact of physical and social-emotional factors on the social functioning of long-term adolescent and young adult (AYA) HSCT survivors. METHODS This cross-sectional analysis included HSCT recipients from the INSPIRE trial [NCT00799461] who received their first transplant between ages 15-39. Patient-reported outcome measures included the Short Form-36v2, Fatigue Symptom Inventory, Cancer and Treatment Distress, and the ENRICHD Social Support Inventory. We used hierarchical multiple linear regression to identify physical and social-emotional factors associated with social functioning at the baseline assessment, with the first block including sociodemographic and clinical factors significant at P = <0.10 in univariate testing, the second block including fatigue and physical function, and the third block including social support and distress. RESULTS Participants (N = 279) were 52% male and 93.5% white, non-Hispanic, with a mean age of 30.3 (SD 6.6) at first transplant. Social Functioning mean was 48.5 (SD 10.5), below age-adjusted norms (t = -13.6, P = <0.001). In the first block, current chronic graft-vs-host disease accounted for 5.5% of the variance (P = <0.001). Adding fatigue and physical function explained an additional 46.6% of the variance (P = <0.001). Adding distress and social support explained an additional 7.7% of the variance (P = <0.001). The final model explained 59.8% of the variance; distress, fatigue, and physical function were significantly associated with social functioning. CONCLUSIONS Distress, fatigue, and physical function are associated with social functioning and interventions targeting these symptoms may help to improve SF among long-term cancer survivors treated with HSCT as AYAs.
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Affiliation(s)
- Casey A Walsh
- Department of Health Services, University of Washington, Seattle, Washington, USA.,Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Jean C Yi
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Abby R Rosenberg
- Cancer and Blood Disorders Center, Seattle Children's Hospital, Seattle, Washington, USA.,Center for Clinical and Translational Research, Palliative Care and Resilience Research Program, Seattle Children's Research Institute, Seattle, Washington, USA.,University of Washington, Cambia Palliative Care Center of Excellence, Seattle, Washington, USA.,Department of Pediatrics, School of Medicine, University of Washington, Seattle, Washington, USA
| | - Marie-Laure V Crouch
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Wendy M Leisenring
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Karen L Syrjala
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.,Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle, Washington, USA
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L'Hotta AJ, Varughese TE, Lyons KD, Simon L, King AA. Assessments used to measure participation in life activities in individuals with cancer: a scoping review. Support Care Cancer 2020; 28:3581-3592. [PMID: 32285262 DOI: 10.1007/s00520-020-05441-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 03/27/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE Individuals with cancer are at high risk for restricted participation in meaningful life activities such as work, school, and social activities. Evaluating participation in life activities is identified as a critical component of rehabilitation referral and triage systems. This scoping review investigates what assessments are used to measure participation in life activities in individuals with cancer. METHODS Six databases were systematically searched using keywords and controlled vocabulary through February 2020. Eligible studies used the term participation in the context of life situations and had an assessment with at least 5 participation-specific questions. RESULTS A total of 4604 unique articles were identified and screened for eligibility. Thirty-two studies were included; 20 unique assessments of participation were identified. Assessments were developed with the primary purpose of measuring participation (n = 8); global or physical function (n = 9); community integration (n = 1); social activity (n = 1); or occupational gaps (n = 1). Most assessments (12/20) were not developed with the purpose of measuring participation and only 4 assessments measured key components of participation other than frequency. CONCLUSION Measuring participation in life activities is a developing area in oncology research. Most studies do not accurately or comprehensively measure this construct. The heterogeneity in assessments used indicates no clear consensus on a gold-standard participation measure for use among cancer survivors. Comprehensively measuring participation will help identify individuals in need of rehabilitation services and is an essential first step to inform the development of targeted interventions to enhance participation.
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Affiliation(s)
| | | | - Kathleen D Lyons
- Dartmouth-Hitchcock Medical Center, Norris Cotton Cancer Center, Lebanon, NH, USA
| | - Laura Simon
- Washington University School of Medicine, St. Louis, MO, USA
| | - Allison A King
- Washington University School of Medicine, St. Louis, MO, USA.,St. Louis Children's Hospital, One Children's Place, St. Louis, MO, USA
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